Loading...
HomeMy WebLinkAboutSubcontractor Agreement PERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division • BUILDING PERMIT SUB-CONTRACTOR AGREEMENT 1� r�+ I have agreed to be (Company Name/Individual Name) the &SCrgic Sub-contractor for (Type of Trade) {n�lr��� Sr-Primary Contractor)f_ For the project located at 15� �NGTo '' Lve-IF3W 3 (Project Street Address or Property Tax ID#) It is understood that, if there is any change of status regarding our participation with the above mentioned project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the filing of a Change of Sub-contractor notice. CONTRACTOR SIGNATURE(Qualifier) SUB-CONTRACTOR SIGNATURE(Qualifier) 1 oPn �E 1 OrA PRINT NAME PRINT NAME CO Y CERTIFICATION BE CO Y CERTIFICATION E „ State of Florida,County o y G��v/� State of Florida,County of / The foregoing instrument was signed before me this t/ day of The foregoing instrument was signed before me this/ day of 20LKby �D V 20S by who is p j.ally known_or has produced a --fA who is personally known or has produced a 1 ',( c^ as identification. as identification. a�th,, l�A,, &AMP /2 �tirt�11IP gnature of Not#Public Sig.ature of Notary blic ­--J h- UL GL `� y � Print Name of N ry Public Prmt Name of Notary)Public �7 fy.°y, AUDREYB.HUMPHREY .: . MY COMMISSION#FF 174772 4_�. B.NUMpHpEY gs EXPIRES:March 6,2019 P + MY'ID'Eye.COMMISSIH FF EY -;' BondedThruNot Pub6cUndeiwriters ;'.�- a�` E ES:March 6,20i92 Revised 11/16/2016 t. l3f��ft"'' �r ,.9� Banded Thru PIR Notary Pubric Underwriters